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which the residence of the sick person was situated, and table " G "
gives particulars of the numbers of cases month by month, together
with the Hospital admissions and discharges.
The duplicate notifications were about six per cent, of the whole,
and represent a cost of about thirteen pounds for fees. The
expenditure of this sum is pure waste, though necessitated by
the wording of the Act. In my opinion, duplicate notifications by
associated Medical Practitioners (partners, principal and assistant,
and institution colleagues) should no longer be required or paid for.
In nine instances the notification certificates were withdrawn by
the Medical Attendant, the lapse of time having afforded an opportunity
to correct the original diagnosis. In ten instances it was
necessary to return the certificate for amendment, as the address
first given was found incorrect. In twelve instances the usual
notification fee of half.a.crown was disallowed by order of the
Sanitary Committee. In two of these there was unnecessary delay
in forwarding the certificate. In ten cases I reported that there
were no grounds to justify the Medical Practitioner reporting the
case as one of infectious disease.
A medical man certified thirteen cases of Membranous Croup
within a month. I made no examination of the first half dozen,
but could not help noticing that the patients did not appear urgently
ill when I visited the premises in the ordinary course of my duties.
One morning I received four of these certificates, so I warned the
certifier that I should personally examine these and any future
cases of Membranous Croup he might report. I did so, but failed
to find symptoms of laryngeal obstruction in any instance. I
reported the result of my examination to the Sanitary Committee,
and the fees for the certificates were disallowed as to the cases I
had personally investigated, together with another certified on Post
Mortem examination only. This was the subject of an Inquest.
The child was found dead in bed ; the Jury brought in a verdict of
suffocation, on the medical evidence; on the same afternoon
I received a notification that the child had suffered from Membranous
Croup, though nothing was said about this before the
Coroner. I may just mention that this was the only fatal case out